Citation

Athié K, Dowrick C, Menezes AL, Cruz L, Lima AC, Delgado PG, Favoretto C, Fortes S. Cien. Saude Colet. 2017; 22(1): 75-86.

Affiliation

Laboratório Interdisciplinar de Pesquisa em Atenção Primária à Saúde, Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro. Boulevard Vinte e Oito de Setembro 77, Vila Isabel. 20551-030 Rio de Janeiro RJ Brasil. karensathie@gmail.com.

Copyright

(Copyright © 2017, Associacao Brasileira de Pos-Graduacao em Saude Coletiva)

DOI

10.1590/1413-81232017221.11732016

PMID

28076531

Abstract

Taking into consideration issues such as stigma and the mental health gap, this study explores narratives of anxious and depressed women treated in a community-based primary care service in a Rio de Janeiro favela about their suffering and care. We analysed 13 in-depth interviews using questions from Kadam's study. Framework analysis studied Access, Gateway, Trust, Psychosocial Issues, and Primary Mental Health Care, as key-concepts. Vulnerability and accessibility were the theoretical references. Thematic analysis found "suffering category", highlighting family and community problems, and "help seeking category", indicating how these women have coped with their emotional problems and addressed their needs through health services, community resources and self-help. Women's language patterns indicated links between implicit social rules and constraints to talk about suffering, especially if related to local violence. High medical turnover and overload are barriers for establishing a positive relationship with family physicians and continuity of care is a facilitator that promotes trust, security and adherence. Concluding, to plan community-based primary mental health care of this population, cultural and social factors must be comprehended as well as the work health teams conditions.

Language: en